I-adenoma ye-villous yamathumbu amakhulu

nguJason Wasserman MD PhD FRCPC
April 8, 2024

I-adenoma enonya uhlobo lwe i-polyp etholakala emathunjini amakhulu ahlanganisa ikholoni kanye ne-rectum. Iqala kusuka amaseli wezindlala ezimboza ingaphakathi lethumbu elikhulu. I-adenoma embi ibhekwa njengesimo esiyingozi ngoba, kuyilapho iningi likhona benign (ezingezona umdlavuza), zinamandla okuthuthuka zibe umdlavuza we-colorectal, kuhlanganise i-adenocarcinoma futhi i-adenocarcinoma ye-mucinous, ngokuhamba kwesikhathi uma ingelashwa. Uma kuqhathaniswa nezivamile i-adenoma ye-tubular, i-adenomas embi inomkhuba omkhulu wokuthuthukela kumdlavuza we-colorectal uma ingasuswa.

Izimpawu ze-adenoma eyingozi

Iningi lama-adenomas anonya ngokuvamile awabangeli zimpawu futhi ngokuvamile atholakala ngengozi phakathi ne-colonoscopy noma ukuhlolwa kwe-imaging. Kodwa-ke, lapho kuvela izimpawu, zingabandakanya:

• Ukopha kwe-rectal noma igazi esitulweni.
• Ukushintsha kwemikhuba yamathumbu (ukuqunjelwa noma isifo sohudo).
• I-Mucus esitokisini.
• Ubuhlungu besisu noma ukungakhululeki.

Kwezinye izimo, i-adenomas enkulu eyingozi ingabangela izimpawu ezibaluleke kakhulu, kuhlanganise nokuntuleka kwe-iron anemia ngenxa yokulahlekelwa igazi okungapheli noma ukuvinjelwa kwamathumbu.

Yini ebangela i-adenoma embi?

Imbangela eqondile ye-adenomas embi ayaziwa, kodwa kucatshangwa ukuthi ikhula ngenxa yenhlanganisela yokuguqulwa kofuzo kanye nezici zemvelo. Izinto eziyingozi ezingase zikhulise amathuba okuthuthukisa i-adenomas embi zihlanganisa:

• Ubudala (ukwanda kwengozi ngokukhula, ikakhulukazi ngaphezu kwama-50).
• Umlando womndeni womdlavuza we-colorectal noma ama-polyps adenomatous.
• Izici zendlela yokuphila njengokudla okunamafutha amaningi, ukudla okunefiber ephansi, ukukhuluphala, ukubhema, nokungazivocavoci.
• Amanye ama-syndromes azuzwe njengefa, njenge-familia adenomatous polyposis (FAP) kanye ne-Lynch syndrome.

Kwenziwa kanjani lokhu kuxilongwa?

Ukuxilongwa kwe-adenoma eyingozi kungenziwa kuphela ngemva kokuba ingxenye noma yonke i-adenoma isusiwe, futhi izicubu zihlolwe ngaphansi kwe-microscope yi-pathologist. I-adenoma ingasuswa ibe yisiqephu esisodwa noma izingcezu eziningi.

Ibukeka kanjani i-adenoma embi ngaphansi kwesibonakhulu?

Ngaphansi kwe-microscope, i-adenoma embi yamathumbu amakhulu ibonakala njenge-polyp eyakhiwe i-dysplastic amaseli we-epithelial ukwakha ubude, izacile, izilinganiso ezifana nomunwe. Uma kuqhathaniswa namaseli avamile, lawa maseli e-dysplastic abonisa ukwanda nyukliya usayizi, i-hyperchromasia (ukwanda kokuqina kwamabala), nangaphezulu nucleus-ku-icyoplasm isilinganiso. Ngokungafani ishubhu futhi tubulovilous i-adenomas, ebonakala njenge-polyp esihlangeni esinezindlala ze-tubular, i-adenomas embi ivame ukuvela njengezilonda eziyisicaba (ezihlangene).

I-Dysplasia yebanga eliphansi uma iqhathaniswa nephezulu ku-adenoma embi

Wonke ama-adenomas amabi abonisa iphethini yokukhula engavamile ebizwa umabhebhana. I-Dysplasia ibalulekile ngoba iwushintsho oluyingozi olungase lube umdlavuza ngokuhamba kwesikhathi. Lapho uhlola i-adenoma embi, izazi ze-pathologists zihlukanisa i-dysplasia zibe amazinga amabili: i-dysplasia yezinga eliphansi kanye ne-high-grade dysplasia.

I-adenoma eyingozi ene-low grade dysplasia

I-dysplasia yezinga eliphansi wushintsho lwangaphambi kwesikhathi olubonakala kuma-adenomas amabi. Uma ishiywe ingalashwa, i-dysplasia yebanga eliphansi ingashintsha ibe yi-dysplasia yebanga eliphezulu noma umdlavuza ngokuhamba kwesikhathi. Nokho, ingozi iyonke yokuthuthukisa lolu shintsho iphansi.

I-adenoma eyingozi ene-high grade dysplasia

I-dysplasia yezinga eliphezulu wushintsho oluthuthuke kakhudlwana lwe-precancerous olubonwa abambalwa be-adenomas embi. Uma ishiywe ingalashwa, i-adenomas embi ene-high grade dysplasia ingaphenduka umdlavuza wekoloni, ngokuvamile. i-adenocarcinoma or i-adenocarcinoma ye-mucinous. Uma kungenzeka, zonke i-adenomas ezimbi ezine-high grade dysplasia kufanele zisuswe ngokuphelele.

Amamajini

A wekhasi yinoma yisiphi izicubu udokotela ohlinzayo asika ukuze asuse i-adenoma embi emzimbeni wakho. I-Dysplasia onqenqemeni lwesicubu kusho ukuthi izicubu ezingavamile kungenzeka ukuthi azizange zikhishwe ngokuphelele emzimbeni.

Amanye ama-adenomas amabi akhula ocezwini lwesicubu olubizwa ngokuthi isiqu, futhi i-adenoma ikhishwa ngokusika isiqu. Kulezi zimo, umkhawulo uyingxenye yesiqu esisikiwe. Kodwa-ke, ama-adenomas amaningi ayasuswa futhi athunyelwe ku-pathology njengezicucu eziningi (izingcezu) zezicubu. Kulezi zimo, kungase kungenzeki ngodokotela wakho wezifo ukuthi anqume ukuthi yiluphi ucezu oluwumkhawulo wangempela futhi izinguquko ezibonwa emaphethelweni ngeke zichazwe embikweni wakho.